Photos by Karen Quincy Loberg / Star staff Physical therapist and clinical supervisor Karen Newsome helps 6-year-old Brianna Martin of Moorpark improve her motor skills at the Child Development Center in Simi Valley.

One Step Forward

Brain tumors have left their mark on Brianna Martin. But with the help of Simi Valley Hospital''s Child Development Center she's making great strides.
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Brianna Martin held a glob of green putty in her right hand and tugged on the stretchy stuff with her left.

"I found one," the 6-year-old Moorpark girl said, pulling a small object from the glob. "It's a bead."

The blue-eyed girl in the yellow Cinderella shirt dropped the hidden treasure in a plastic container. All around her, other children squealed in delight in the room filled with pint-sized attractions.

Within this cheerful day care environment, the Child Development Center operates as one of Simi Valley Hospital's outpatient clinics. The 7,200-square-foot facility is one of the region's few that offer a spectrum of services — including physical, occupational, speech and music therapy — under one roof, in homes and in the community. It serves children drawn from the county and the western San Fernando Valley.

Play is work and toys are tools at the center.

A squishy pit, filled with a rainbow assortment of plastic balls, helps develop balance. Pictures foster communication in autistic children. Green, stretchy stuff helps build strength in a little girl's right hand, curled and weakened by a brain tumor.

"You have to use play as the medium for children to learn, because that's what they do," said Robin Millar, the center's administrative director. "Those are their tools."

The clinic serves children who don't have an obvious disorder but are not developing on time, and others with diagnoses like Down syndrome or autism.

Rapid growth

Brianna and Kathy Anderson, an occupational therapist, sat at a child-size table, each holding a rubbery, tentacled toy in their hands.

"Up, up, up," they said in unison, raising their arms. "Down, down, down."

Brianna has limited mobility in her right arm and leg. She is one of more than 500 children in programs offered at the center.

The center opened in 1979 with seven children in an early intervention program. The program, for infants to 3-year-olds, helps children who are developmentally delayed or disabled.

"All the families that lived in eastern Ventura County had to travel to Ventura to get services at that time," said Millar, who has been with the center since it opened.

As the children got older, the need for more services increased. Today, the center serves 225 children under the age of 3 and 300 older than that.

Brianna was little more than a year old when her parents first took her to the center. The second daughter of Stephanie and Ed Martin, Brianna was delivered normally and was a healthy infant.

But the Moorpark couple noticed their baby wasn't crawling normally. She scooted on her bottom. At their pediatrician's urging Brianna underwent magnetic resonance imaging, which took images of her brain.

The day of the procedure, Stephanie went to clip Brianna's fingernails. The 15-month-old was right-hand dominant but her hand was curled inward.

"It was kind of a trigger to me that something was not quite right — that mom instinct," said Stephanie Martin, 32.

The radiologist put Brianna's results in a sealed envelope and told the couple to take it to her doctor.

"We got there, and I never expected him to say Your daughter has a tumor one-third the size of her brain,'" said Martin, who was 9 1/2 weeks pregnant with her third daughter, Brandi.

Exercise through play

On a Thursday in early spring, Brianna was recuperating from a cold. Physical therapist and clinical supervisor Karen Newsome tried to coax the little girl through the day's activities.

"Do you want to surf?" Newsome asked, leading Brianna to a curved, padded board covered in light green fabric.

"The surfing promotes a lot of different things," Newsome said later. "It's for working on trunk strengthening. She needs to work on getting better control in her legs."

Brianna stood still on the center of the board. Her mother joined her, gently shifting her weight, causing the board to rock back and forth.

"It's actually easier for them to express themselves," Millar said of using toys, games and puzzles as part of therapy. "You can't say to a little munchkin pie, OK, you need to drop and give me pushups now.' So we need to learn to strengthen the body against gravity in kind of creative ways."

Brianna's surgery to remove the malignant brain tumor in 2002 left her weak and unable to stand.

The surgeon at Childrens Hospital Los Angeles told the Martins they were able to remove all but 2 percent of the tumor because it was too deep in her brain stem, and going further down could leave their daughter in a vegetative state.

The couple, surrounded by family, kept an agonizing vigil during the 3 1/2 hours Brianna was in surgery.

"It was so, so scary," Martin said. "The only thing that kept me going was my faith in God, that he would keep her going."

Despite the severity of her surgery, that night Brianna ate macaroni and cheese and watched the children's group The Wiggles on the television in her hospital room.

More therapists needed

The week after Brianna's cold, the little girl and her mother are back at the center. This time, she is joined by her sisters. Brooke is the oldest at 7, Brandi is 5, and Bella is a little more than a year old.

Their mother calls them "The Four Bs."

Amid the toys and therapy contraptions, the girls giggled and played. Brianna handed Bella one of the colored round pegs she was putting in a board.

"Use Rightie," Anderson told Brianna, referring to her right hand.

Laurie Johnson, director at the Rainbow Connection Resource Center in Oxnard, said parents she has worked with who have used the Child Development Center have loved it, but there is still a need in the county for more therapists and resources, particularly speech therapists.

Johnson, whose organization offers parent support, resource referrals, support groups and a resource library, pointed to Easter Seals in Ventura and Amigo Baby Inc. in Oxnard as other noted service providers.

"I love it when people do something positive," Johnson said.

The Martins first took Brianna to the Child Development Center before her tumor was diagnosed. They thought she might have a shoulder condition, and the couple instantly liked her therapists.

The family was back not long after Brianna's surgery. The little girl couldn't walk or pull herself into a standing position. Brianna was in therapy four days a week, two days each for physical and occupational therapy.

Three months later, during a follow-up scan of her brain, the family learned the small part of the tumor left behind had quadrupled in size.

Brianna underwent a second surgery and then a third to place a ventricular shunt in her head to drain fluid from her brain.

Then there were 13 months of chemotherapy, which ended in April 2004.

She has since been in remission. She attends therapy once a week, and one of her goals is to jump.

Brianna was working on walking up and down steps with Newsome one afternoon as Stephanie Martin sat on one of the center's tiny chairs.

"Karen and Kathy became family, and basically taught her everything she knows," Martin said.